What Medicaid Is and Who Runs It

Medicaid is a joint federal and state health insurance program for people with low income. Unlike Medicare, which is federal and based on age or disability, Medicaid is run by each state with federal money and rules. This means the program looks different depending on where you live — what it covers, who it serves, and how to contact it all vary by state.

Each state has its own Medicaid agency, usually called the Department of Human Services, Department of Social Services, or Department of Health and Human Services. You contact your state's agency, not a national office. Your state's Medicaid program covers doctor visits, hospital care, prescription drugs, and other medical services for people who meet income and other requirements.

Medicaid is different from private health insurance you buy yourself. It is not something you purchase — it is a program you may be able to use if your income and circumstances fit the rules your state has set. The program pays doctors and hospitals directly, so you do not pay a premium to Medicaid itself, though some states charge small copays when you use services.

Key Takeaways

  • Medicaid is run by your state, not the federal government, so the income limits, covered services, and how to contact your program all depend on where you live.
  • You contact your state's Medicaid agency directly — usually the Department of Human Services or Department of Social Services — to learn whether you may be able to use the program.
  • Income limits vary widely by state and family size, and some states have expanded Medicaid while others have not, which changes who can use it.
  • You will need to provide proof of income, citizenship or immigration status, and residency when you contact your state program.
  • Once you are using Medicaid, you receive a card that you show to doctors and hospitals, and Medicaid pays them directly for covered services.

Income Limits and Who Can Use Medicaid

Medicaid serves people with low income, but the exact income limit depends on your state and family size. A single person in one state might have a different limit than a single person in another state. Some states have expanded Medicaid to cover more people; others have not. You cannot know whether you meet the income requirement without checking your specific state's rules.

Beyond income, Medicaid typically requires you to be a U.S. citizen or may have access to immigrant, a resident of the state where you are explore, and either a child, parent, pregnant person, elderly person, or person with a disability. Some states have additional categories. The best way to find out whether you may be able to use Medicaid is to contact your state's Medicaid agency directly and describe your situation — they can tell you in one conversation whether the program is available to you.

Your state's Medicaid agency can be found by searching "[Your State] Medicaid" online or by calling 211, a free helpline that connects you to local programs. When you call or visit the website, have your income information ready — usually your last two pay stubs or tax return — because the agency will ask about it right away.

How to Contact Your State's Medicaid Program

Each state runs Medicaid differently, so there is no single national number to call. Instead, you need to reach your state's Medicaid agency. The fastest way is to search "[Your State] Medicaid" in a web browser, which will take you to your state's official Medicaid website. From there, you can usually find a phone number, an online form, or an office address.

If you do not have internet access or prefer to call, dial 211. This free helpline is available in all 50 states and connects you to local programs and services. Tell them you want to reach your state's Medicaid program, and they will give you the phone number and office locations near you. You can also visit your local health department or social services office in person — staff there can often help you contact Medicaid or even start the process on the spot.

When you reach your state's Medicaid agency, be ready to answer questions about your income, family size, citizenship status, and where you live. Have your Social Security number, proof of income (pay stubs or tax return), and proof of residency (utility bill or lease) nearby. The agency will tell you what documents you need to send or bring in.

Documents You Will Need

Medicaid agencies ask for proof of several things. You will need to show your income — usually your last two pay stubs, a tax return, or a letter from your employer saying how much you earn. If you are self-employed or do not have regular pay stubs, bring tax returns or bank statements showing your income.

You will also need proof of citizenship or immigration status. A birth certificate, passport, or naturalization papers work for citizenship. If you are an immigrant, bring your green card, visa, or other immigration document. Your state's Medicaid agency can tell you which documents they accept.

Finally, bring proof that you live in the state — a utility bill, lease, mortgage statement, or government mail with your address on it. Some states also ask for proof of identity, like a driver's license or ID card. Ask your state's Medicaid agency which documents they need before you gather everything, because requirements vary.

What Medicaid Covers

Medicaid covers doctor visits, hospital stays, emergency care, prescription drugs, and mental health services. Most states also cover dental care, vision care, and physical therapy. The exact list of covered services varies by state — some cover more than others.

When you use Medicaid, you show your Medicaid card to the doctor or hospital. The provider bills Medicaid directly, and Medicaid pays them. You do not pay the full bill yourself. Some states charge small copays — usually a few dollars — when you visit a doctor or fill a prescription, but you will not face a large bill.

Not every doctor or hospital takes Medicaid. When you receive your Medicaid card, your state will send you a list of doctors and hospitals in your area that accept it. You can also call the number on your card to ask whether a specific provider takes Medicaid before you make an appointment.

How to Use Your Medicaid Card Once You Receive It

If your state's Medicaid agency determines that you may be able to use Medicaid, they will send you a card in the mail. The card has your name, a member ID number, and the phone number to call if you have questions. Keep this card with you when you go to the doctor or hospital.

When you arrive at a doctor's office or hospital, tell the front desk staff that you have Medicaid and show them your card. They will make a copy or take down your member ID number. The provider will bill Medicaid for the visit, and Medicaid will pay them. You may be asked to pay a small copay at the time of your visit — usually two to five dollars — but that is all you owe.

If you lose your card, call the number on your old card or contact your state's Medicaid agency to request a replacement. If you move to a different state, your Medicaid from your old state will not work in your new state. You will need to contact your new state's Medicaid agency and go through the process again.

What Happens If Your Income Changes

Medicaid is based on your current income, so if your income goes up or down, you need to tell your state's Medicaid agency. If your income increases above your state's limit, you may no longer be able to use Medicaid, and your coverage will end. If your income decreases, you may become able to use Medicaid, or you may be able to use it with different terms.

Most states ask you to report income changes within 30 days. You can usually report a change by phone, online, or by mail — your Medicaid card or paperwork will tell you how. If you do not report a change and your income is actually above the limit, you may have to repay some of the money Medicaid spent on your care, though this varies by state.

If you lose your job or your hours are cut, contact your state's Medicaid agency right away. A drop in income may mean you can start using Medicaid or that your coverage can continue. Many states have special rules for people who lose employment, so it is worth calling to ask.

Frequently Asked Questions

Can I use Medicaid from one state if I move to another state?

No. Medicaid is run by each state separately, so your coverage ends when you move. You will need to contact your new state's Medicaid agency and go through the process again. Some states process new applications faster than others, so there may be a gap in coverage. Contact your new state's program as soon as you move to minimize any gap.

What if I have a job but my income is still low enough for Medicaid?

You can use Medicaid even if you work. Medicaid is based on income, not on whether you are employed. If your job pays less than your state's Medicaid income limit, you may be able to use Medicaid. Contact your state's Medicaid agency with your income information, and they will tell you whether you meet the requirement.

Do I have to pay Medicaid back if my income goes up later?

Not usually. Once Medicaid pays for your care, you do not owe that money back if your income increases later. However, if you did not report an income increase and Medicaid paid for your care when you were actually above the income limit, some states may ask you to repay part of what they spent. This varies by state, so ask your Medicaid agency about their rules.

Can I use Medicaid and Medicare at the same time?

Yes. Some people are old enough or disabled enough to may have access to for Medicare and also have low enough income to may have access to for Medicaid. When you have both, Medicare is your primary insurance and Medicaid is secondary. Medicaid may help pay Medicare premiums and copays. Contact your state's Medicaid agency to ask whether you may be able to use both programs.

What if I am not a U.S. citizen?

Some immigrants can use Medicaid, but not all. Lawful permanent residents (green card holders) and certain other visa holders may be able to use it. Undocumented immigrants cannot use regular Medicaid in most states, though some states offer emergency-only coverage. Contact your state's Medicaid agency with information about your immigration status, and they will tell you what options are available to you.